Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 0443455 | KS |
N | 2086X0206X | Surgical Oncologist | 2016008913 | MO |
NPI | 1225341068 |
---|---|
Provider Name | Dr. Jennifer Andrea Hawasli |
First Address | Saint Louis, MO 63128-3286 |
Second Address | Lawrence, KS 66049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2010 |
Last Update Date | 01/12/2020 |